# JEFFERSON NEUROLOGY CLINIC, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1518486943
- **Authorized official:** AREMMIA TANIOUS (OWNER)
- **Authorized official phone:** (601) 426-2140

## Contact information

- **Practice address:** 319 S 13TH AVE, LAUREL, MS 39440-4342
- **Practice address phone:** (601) 649-2863
- **Mailing address:** 319 S 13TH AVE, LAUREL, MS 39440-4342

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261Q00000X | Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 09/18/2017
- **Last updated:** 01/27/2024